FLS Module 3 - basic laparoscopic
procedures UPDATED Exam Questions and
CORRECT Answers
What are some of the newest developments in laparoscopic surgery? - CORRECT
ANSWER - Robotic assistance, single port site procedures, Natural Orifice Translumenal
Endoscopic Surgery (NOTES), and intrauterine fetal surgery
List 5 laparoscopic procedures that are performed on newborn infants - CORRECT
ANSWER - appendectomy, undescended testes, anti-reflux surgery, pectus repair, PDA,
intestinal atresia, pyloromyotomy, and surgery for Hirschsprung's disease
Indications for diagnostic laparoscopy - CORRECT ANSWER - elective - cancer staging,
chronic abdominal pain
urgent - small bowel obstruction, vs ileus
Emergent - trauma, suspected iatrogenic injury, perforated viscous
During what procedures could you inadvertently enter the peritoneal cavity and subsquently need
to perform a diagnostic laparoscopy? - CORRECT ANSWER - hysteroscopy, endoscopy
Key elements of performing a lysis of adhesions - CORRECT ANSWER - Use both blunt
and sharp dissection with gentle traction on tissue. Be cautious and sparingly use energy sources
for hemostasis to avoid thermal spread
What is the best position for patients getting surgery on the upper abdomen? - CORRECT
ANSWER - Arms on arm boards, reverse trendelenburg position with a footboard and
safety strap on lower thighs to keep patient from sliding. Monitors placed at head of table for
viewing operative field.
What is the key to patient positioning? Where would you place your initial port for a diagnostic
lap where you need to view the entire abdomen? After your initial port, where do you place
additional ones? - CORRECT ANSWER - Maximize the ergonomics of the surgeon and
, assistant. Usually initiate access in LUQ and 2 additional ports can also be placed in the left
abdomen (then surgeon and assistant can stand on left side together). This allows the entire
abdomen to be visualized except for immediately below the ports or lateral to the ports.
General principles of diagnostic lap of the liver - CORRECT ANSWER - Angled scope
Tools for biospy and hemostasis
May need ultrasound to visualize structures under the surface.
To see anteriorly: may need adhesiolysis
To see posteriorly: may need special liver retractor or careful use of blunt instruments
Why would you do a diagnostic lap of the anterior abdominal wall?
What area should you enter the abdomen?
What degree scope should you use? - CORRECT ANSWER - To look for evidence of
post-op bleeding, adhesions, hernia or tumor.
Left upper quadrant, unless the area of interest is in the LUQ.
30 degree scope
Best position and port placement for diagnostic pelvic laparoscopy - CORRECT
ANSWER - - Tucked arms so surgeon can be ergonomically favorable.
- Trendelenburg
- Ports at or above the umbilicus
- Retract uterus with manipulator or suture retraction to the abdominal wall.
Diagnostic lap for suspected appendicitis - CORRECT ANSWER - - Left arm tucked,
allowing surgeon and assistant to stand on left side.
- T-burg
- Rotate slightly to a "right side up" orientation
- Secure patient adequately to table
procedures UPDATED Exam Questions and
CORRECT Answers
What are some of the newest developments in laparoscopic surgery? - CORRECT
ANSWER - Robotic assistance, single port site procedures, Natural Orifice Translumenal
Endoscopic Surgery (NOTES), and intrauterine fetal surgery
List 5 laparoscopic procedures that are performed on newborn infants - CORRECT
ANSWER - appendectomy, undescended testes, anti-reflux surgery, pectus repair, PDA,
intestinal atresia, pyloromyotomy, and surgery for Hirschsprung's disease
Indications for diagnostic laparoscopy - CORRECT ANSWER - elective - cancer staging,
chronic abdominal pain
urgent - small bowel obstruction, vs ileus
Emergent - trauma, suspected iatrogenic injury, perforated viscous
During what procedures could you inadvertently enter the peritoneal cavity and subsquently need
to perform a diagnostic laparoscopy? - CORRECT ANSWER - hysteroscopy, endoscopy
Key elements of performing a lysis of adhesions - CORRECT ANSWER - Use both blunt
and sharp dissection with gentle traction on tissue. Be cautious and sparingly use energy sources
for hemostasis to avoid thermal spread
What is the best position for patients getting surgery on the upper abdomen? - CORRECT
ANSWER - Arms on arm boards, reverse trendelenburg position with a footboard and
safety strap on lower thighs to keep patient from sliding. Monitors placed at head of table for
viewing operative field.
What is the key to patient positioning? Where would you place your initial port for a diagnostic
lap where you need to view the entire abdomen? After your initial port, where do you place
additional ones? - CORRECT ANSWER - Maximize the ergonomics of the surgeon and
, assistant. Usually initiate access in LUQ and 2 additional ports can also be placed in the left
abdomen (then surgeon and assistant can stand on left side together). This allows the entire
abdomen to be visualized except for immediately below the ports or lateral to the ports.
General principles of diagnostic lap of the liver - CORRECT ANSWER - Angled scope
Tools for biospy and hemostasis
May need ultrasound to visualize structures under the surface.
To see anteriorly: may need adhesiolysis
To see posteriorly: may need special liver retractor or careful use of blunt instruments
Why would you do a diagnostic lap of the anterior abdominal wall?
What area should you enter the abdomen?
What degree scope should you use? - CORRECT ANSWER - To look for evidence of
post-op bleeding, adhesions, hernia or tumor.
Left upper quadrant, unless the area of interest is in the LUQ.
30 degree scope
Best position and port placement for diagnostic pelvic laparoscopy - CORRECT
ANSWER - - Tucked arms so surgeon can be ergonomically favorable.
- Trendelenburg
- Ports at or above the umbilicus
- Retract uterus with manipulator or suture retraction to the abdominal wall.
Diagnostic lap for suspected appendicitis - CORRECT ANSWER - - Left arm tucked,
allowing surgeon and assistant to stand on left side.
- T-burg
- Rotate slightly to a "right side up" orientation
- Secure patient adequately to table
